Individual and Family Plan Provided Health Care Services
Qualified health plans sold in the Public Marketplace and every health plan offered in the Private Marketplace must offer the following 10 essential health benefits regardless of the plan’s metal level. As long as you’re in network, the benefits apply.
Ambulatory patient services (outpatient care you get without being admitted to a hospital)
Emergency services
Hospitalization, such as surgery and overnight stays
Pregnancy, maternity, and newborn care before and after birth
Mental health and substance use disorder services, including behavioral health treatment (counseling, psychotherapy, etc.)
Prescription drugs
Rehabilitative and habilitative services and devices to assist people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills
Laboratory services
Preventive, wellness services, and chronic disease management
Pediatric services, including dental and vision care for children
There are no annual or lifetime limits on these plans.